THE STATE OF MEDICAL IMAGE ARCHIVING:

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1 Introduction The increase in the availability and quality of medical images is enabling healthcare providers to successfully diagnose and resolve more patient problems than ever before. The downside is the demand placed on IT organizations to retain numerous medical images with huge file sizes in a reliable, secure, scalable, and accessible environment. As a result, IT organizations struggle to effectively deliver adequate storage while keeping costs under control. So how are healthcare organizations dealing with these issues? Are they sacrificing cost for compliance? Are they embracing new cloud-based storage solutions? The following report is based on a survey of 568 healthcare IT professionals conducted at the annual HIMSS (Healthcare Information and Management Systems Society) Event in February The goal of the survey was to gather data about current plans and attitudes among healthcare organizations for securing and storing medical images. Key Findings High levels of concern about disaster recovery: 55% of participants say that concerns about disaster recovery for their medical images keep them up at night. Aggressive plans in place to adopt cloud storage for medical images: While only of participants report that they are actively using cloud-based vendors for archiving medical images today, 58% are using or have plans to use cloud for medical image storage. Image archiving not in line with HIPAA recommendations: 6 of participants report that their organizations do not follow HIPAA recommendations for storing their medical images. 41% report that they are very concerned about staying in compliance with HIPAA. Details Healthcare IT professionals very concerned about disaster recovery Participants were asked what keeps you up at night regarding their medical image storage. The greatest concern reported was disaster recovery with more than half of participants (55%) indicating that it was a significant issue. See Figure A. Interestingly, these concerns about disaster recover are occuring in spite of efforts to keep multiple copies of images. The vast majority (82%) of participants report keeping two or more copies of medical images in their archives. Sponsored by

2 Figure A: What keeps healthcare IT professionals "up at night" Disaster recovery 55% HIPAA compliance 41% Providing physicians with beder access 30% Reducing costs 22% Reducing vendor dependancy (i.e. PACS vendor dependancy) 10% 0% 10% 20% 30% 40% 50% 60% Aggressive plans to adopt cloud solutions for storing medical images Regardless of the challenges cited with image archiving storage, only of participants reported that they use a cloud-based solution today. However, there are very strong interests in cloud approaches with an additional 4 of participants citing plans to use cloud-based storage in the future (a total of 58% using or planning to use cloud image archiving). See Figure B. Figure B: Use Cloud for Image Archiving Already using Not using or planning to use 42% Planning to use 4 The 42% of participants who do not have plans to use a cloud-based image archiving solution were asked what their concerns were. Security was the most cited response () followed by performance (25%). See Figure C. Figure C: Concerns with cloud storage Concerned with security Concerned with performance Concerned with price Concerned with vendor lock- in Don't trust it / Technology is too recent 4% 6% 1 25% 0% 5% 10% 15% 20% 25% 30% 35% Page 2

3 Image archiving not in line with HIPAA recommendations HIPAA (Health Insurance Portability and Accountabilty Act) includes clear recommendations 1 for the storage of medical images. Options that satisfy both the letter and spirit of the mandate, and provide a form of risk management insurance, include: Back-up electronic protected health information (ephi) in a second, secure data center operated by the healthcare entity, preferably at a site more than 100 miles from the primary site. Rent space and functionality at a tier-3 or tier-4 data center located at more than 100 miles from the healthcare facility. Store ephi in multiple data centers owned by the healthcare entity and utilize grid-storage technology. Outsource the management and storage of ephi for disaster recovery, and possibly for long-term storage, to a storage service provider (SSP). However, the majority of participants (6) do not follow these recommendations, with only reporting that their medical images are stored in data centers that are more than 100 miles apart. Surprisingly, 36% of participants report that they go to the effort and cost of storing images in multiple locations, but the locations are less than the 100 miles apart recommended by HIPAA. See Figure D. Figure D: Loca.on of archived medical images Mul1ple data centers located 100+ miles apart Single data center 33% Mul1ple data centers located < 100 miles apart 36% Hospitals were much more likely to not follow HIPAA recommendations than freestanding imaging centers or radiology practices. Only 20% of hospitals stored their archives in multiple locations more than 100 miles apart compared to 36% of freestanding imaging centers or radiology practices. A wide range of storage media in use Participants reported extensive use of tape or CDs (42%) and even film () to store their medical images. Surprisingly, 16% of respondents continue to use only older forms of storage and have not yet invested in hard disk drives or spinning disks for their storage. See Figure E. 1 Smith EM. Risk Management. Advance for Imaging & Radiation Oncology, in press and Storage management: What radiologists need to know Page 3

4 Figure E: Type of storage media in use Hard disk drives / "Spinning disks" 84% Tape/CD 42% Film 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% And, there was no clear leader among the in-house hard disk drive solutions used by participants for medical image archiving. See Figure F. Figure F: Storage Vendors Any Cloud- based Vendor EMC IBM Dell HP NetApp Hitachi 6% 10% 27% 34% 38% 0% 5% 10% 15% 20% 25% 30% 35% 40% Survey Methodology In February 2011, attendees at the HIMSS 2011 (Healthcare Information and Management Systems Society) annual conference were surveyed to gather data about current plans and attitudes among healthcare organizations for securing and storing medical images. HIMSS is attended by healthcare industry experts who are interested in learning about the latest solutions for improving healthcare through IT. The survey was completed by 568 IT professionals who are working in healthcare. Participants represented a wide range of organizations responsible for the technology used to store and access medical images including hospitals, imaging centers, radiology practices, multi-hospital systems, and more. Page 4

5 The survey was conducted in the Symantec booth on the HIMSS 2011 tradeshow floor. Respondents were incented to participate in the survey by being offered a copy of the final report, as well as being entered into a drawing for an Apple ipad. The survey sponsor, Symantec, was revealed to participants prior to their participation. About Dimensional Research Dimensional Research provides practical marketing research to help technology companies make smarter business decisions. Our researchers are experts in technology and understand how corporate IT organizations operate. Our research services deliver a clear understanding of customer and market dynamics. For more information visit. About Symantec Corporation Symantec is a global leader in providing security, storage and systems management solutions to help consumers and organizations secure and manage their information-driven world. Our software and services protect against more risks at more points, more completely and efficiently, enabling confidence wherever information is used or stored. More information is available at Symantec and the Symantec Logo are trademarks or registered trademarks of Symantec Corporation or its affiliates in the U.S. and other countries. Page 5